Orbitofrontal Craniotomy for Anterior Cranial Fossa Giant Meningiomas

Objective: To evaluate the safety and efficacy of orbitofrontal craniotomy (OFC) for anterior cranial fossa giant meningiomas.

Materials and Methods: Twenty-seven patients, 16 females and 11 males, were treated with OFC between 2005 and 2011. The anterior cranial fossa giant tumor patients that invaded the skull base were qualified to the OFC for better control of intrasurgical bleeding and to achieve complete removal of the tumor. The procedures were performed in the supine position. Bicoronal skin incisions were performed in all cases. One or two block OFCs were performed. Extra- and intradural approaches were used to remove the tumor. Cranialization of the frontal sinuses and duraplasty were performed in every case. The surgery lasted from 4 to 10 hours. Hospitalization lasted from 6 to 13 days.

Results: Macroscopically total removal was achieved in all patients. Pathology examination revealed giant meningiomas (WHO grade I) in all cases. No perioperative mortality or morbidity was recorded in the group.

Conclusions: The OFC approach is a safe surgical option for resection of giant meningiomas of the anterior cranial fossa.